Provider Demographics
NPI:1366434425
Name:WORCESTER EYE CONSULTANTS, PC
Entity type:Organization
Organization Name:WORCESTER EYE CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:ZACHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-791-8484
Mailing Address - Street 1:33 LANCASTER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2615
Mailing Address - Country:US
Mailing Address - Phone:508-791-8484
Mailing Address - Fax:
Practice Address - Street 1:33 LANCASTER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2615
Practice Address - Country:US
Practice Address - Phone:508-791-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA93087OtherFALLON GROUP ID
MA96629101OtherNETWORK HEALTH GROUP ID
MA0801744OtherEVERCARE GROUP ID
MA637388OtherTUFTS GROUP PROVIDER ID
MA9763601Medicaid
MAKG66OtherHARVARD PIGRIM HEALTH CAR
MAM18982OtherBLUE SHIELD GROUP ID
MA96629101OtherNETWORK HEALTH GROUP ID